{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:38:01Z","timestamp":1782517081905,"version":"3.54.5"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,14]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Rapidly progressive ascites is a frequent clinical manifestation of advanced abdominal malignancies or portal hypertension due to liver diseases. We report a case of 61-year-old man who presented with rapidly progressive ascites. The presence of ascites, generalised lymphadenopathy, osteosclerosis on imaging and hepatosplenomegaly initially pointed towards the diagnosis of advanced high-grade lymphoma or accelerated myeloid neoplasm. Lymph node biopsy revealed infiltration by CD45, cKIT and CD30; tryptase and toluidine blue-positive mast cells (MCs). Bone marrow examination revealed infiltration by MCs and next generation sequencing revealed the pathognomic exon 17 D 816V KIT mutation. The patient was started on weekly pegylated interferon with significant symptom relief. Systemic mastocytosis should be considered as a differential diagnosis in a clinical case of ascites of unknown aetiology even in the absence of typical skin manifestations.<\/jats:p>","DOI":"10.1136\/bcr-2020-238034","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T16:14:56Z","timestamp":1612800896000},"page":"e238034","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Aggressive systemic mastocytosis presenting as rapidly progressive ascites, generalised lymphadenopathy and osteosclerosis"],"prefix":"10.1136","volume":"14","author":[{"given":"Vijayalakshmi Aravindan","family":"Arun","sequence":"first","affiliation":[{"name":"Department of Clinical Hematology, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipesh","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1457-8589","authenticated-orcid":false,"given":"Amanjit","family":"Bal","sequence":"additional","affiliation":[{"name":"Department of Histopathology, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9495-9789","authenticated-orcid":false,"given":"Arihant","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,8]]},"reference":[{"key":"2025082702494188000_14.2.e238034.1","unstructured":"Horny HP , Akin C , Arber D . 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